BMC Anesthesiology最新文献

{"title":"Evaluation of dynamic brain function in patients with different degrees of chronic pain by EEG microstate analysis.","authors":"Yi-Qi-Yuan Zhang, Ya-Ru Li, Qi Han, Fei Gao, Yi Feng","doi":"10.1186/s12871-025-03326-1","DOIUrl":"10.1186/s12871-025-03326-1","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain is closely associated with functional remodeling of the central nervous system. The neuroplasticity in the brain can be characterized by the electroencephalography (EEG) microstate analysis of the static topological features of resting-state functional brain networks.</p><p><strong>Methods: </strong>Seventy-four patients undergoing spinal surgery for chronic pain were included. Preoperative resting-state EEG recordings were obtained, and patients were stratified into two groups according to their preoperative Numerical Rating Scale (NRS) pain scores. From the EEG data, four specific microstates (labeled A, B, C, and D) were extracted, and their temporal characteristics were analyzed. Statistical analysis was performed to compare the microstate characteristics between the two groups, and to examine the correlation between microstate characteristics and pain intensity.</p><p><strong>Results: </strong>In the high-pain (HP) group, microstate D exhibited significantly reduced occurrence frequency, time coverage, and duration compared with the low-pain (LP) group. In addition, differences in microstate transition patterns were observed between the two groups. A significant correlation was also observed between the temporal characteristics of microstate D and the preoperative pain intensity, as measured by the NRS.</p><p><strong>Conclusion: </strong>Alterations in microstate dynamics during the preoperative resting state may reflect changes in brain functions among patients with chronic pain. EEG microstate analysis may be recommended for identifying changes in brain dynamics associated with chronic pain.</p><p><strong>Trial registration: </strong>This study was registered on ClinicalTrials.gov prior to patient enrollment (Registration number: NCT03761576; Registration date: November 30, 2018).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"491"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of perioperative analgesic efficacy between serratus anterior plane block and thoracic paravertebral block in adult patients undergoing thoracic and breast surgeries: a systematic review and meta-analysis.","authors":"Junxing Wang, Ting Li","doi":"10.1186/s12871-025-03343-0","DOIUrl":"10.1186/s12871-025-03343-0","url":null,"abstract":"<p><strong>Background: </strong>Serratus anterior plane block (SAPB) and thoracic paravertebral block (TPVB) are widely used regional anesthesia techniques for postoperative analgesia and are generally considered safe and effective. However, the comparative efficacy remains inconclusive. This systematic review and meta-analysis of randomized controlled trials (RCTs) aims to evaluate the perioperative analgesic efficacy of SAPB versus TPVB in adult patients undergoing thoracic and breast surgeries.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science, Cochrane library, ClinicalTrial.gov, and Google Scholar up to February 28, 2025. Primary outcomes included time to first analgesic request (TFAR), 24-h total analgesic consumption (TAC) postoperatively, and 24-h postoperative pain scores at rest. Secondary outcomes comprised pain scores at various postoperative timepoints, intraoperative fentanyl consumption, length of hospital stay, patient satisfaction with analgesia, and incidence of complications. A random-effect model was applied for the meta-analysis.</p><p><strong>Results: </strong>Twenty-eight 28 RCTs comprising 1796 patients were included. No significant differences were found between SAPB and TPVB in TFAR (mean difference [MD] = -0.68 h, 95% confidence interval [CI]: -1.55 to 0.18, P = 0.122), 24-h pain scores at rest (MD = 0.14, 95%CI: -0.14 to 0.42, P = 0.334), other postoperative pain scores, length of hospital stay, patient satisfaction, or incidence of postoperative nausea and vomiting (risk ratio [RR] = 0.87, 95%CI: 0.63 to 1.20, P = 0.310). Despite statistically significant, the difference of 24-h TAC comparing SAPB to TPVB (MD = 1.73 mg intravenous morphine equivalents, 95%CI: 0.54 to 2.92, P = 0.005) did not exceed the minimal clinically important difference (MCID) of 10 mg. SAPB also resulted in greater intraoperative fentanyl consumption (MD = 13.85 mcg, 95%CI: 3.86 to 23.84, P = 0.007) but a significantly lower incidence of hypotension (RR = 0.39, 95%CI: 0.20 to 0.76, P = 0.006). Subgroup analyses showed that TPVB provided superior, but non-clinically significant, opioid-sparing benefits in thoracic procedures (3.38 mg) and when compared to superficial SAPB (3.11 mg).</p><p><strong>Conclusion: </strong>SAPB offers comparable analgesic efficacy to TPVB, with a more favorable safety profile but slightly higher opioid consumption. However, the increased opioid use does not exceed the MCID. Therefore, SAPB is a clinically effective and safe alternative to TPVB for perioperative regional analgesia in thoracic and breast surgeries.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"493"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of hemodynamics and respiratory function between ciprofol-remifentanil and propofol-remifentanil in obese patients undergoing gastrointestinal endoscopic anesthesia: a randomized controlled trial.","authors":"Chunfang Jian, Minghua Zhang, Xiaochun Zhong, Xihua Li, Hangxiang Fu, Ying Chen, Yi Shen","doi":"10.1186/s12871-025-03360-z","DOIUrl":"10.1186/s12871-025-03360-z","url":null,"abstract":"<p><strong>Background: </strong>To assess the safety of ciprofol for painless gastroenteroscopy in obese patients by comparing the effects of ciprofol-remifentanil and propofol-remifentanil on hemodynamic parameters, respiratory function, and other adverse reactions.</p><p><strong>Methods: </strong>A total of 70 obese patients who underwent painless gastrointestinal endoscopy at Longyan First Hospital of Fujian Medical University (Longyan, China) from September 2023 to February 2024 were enrolled. They were randomly assigned into the propofol group (Group A) and the ciprofol group (Group B) by a random number table. Group A received propofol combined with remifentanil anesthesia during the endoscopy, while Group B received ciprofol combined with remifentanil anesthesia. The systolic blood pressure, diastolic blood pressure, heart rate, and peripheral capillary oxygen saturation (SpO₂) levels were compared between the two groups at pre-anesthesia (T0), 1-min post-anesthesia (T1), 3-min (T2), 6-min (T3), 12-min (T4), and 5-min post-recovery (T5). Arrhythmias, hypotension, tachycardia, bradycardia, and the use of vasoactive drugs were documented. Additionally, the incidence and average severity of hypoxemia, the average duration of hypoxemia, and the average minimum SpO₂ level were recorded. The occurrence rates of jaw thrust, mask ventilation, nasopharyngeal airway insertion, tracheal intubation, and other adverse reactions were recorded.</p><p><strong>Results: </strong>Compared with Group A, Group B exhibited significantly higher blood pressure levels at T1 and T2, as well as higher SpO₂ levels at T1, T2, and T3 (P < 0.05). The incidence of hypotension was lower in Group B (P < 0.05), and no significant differences were identified in arrhythmias, tachycardia, bradycardia, or the use of vasoactive drugs between the two groups. Group B also demonstrated a lower incidence of hypoxemia, reduced average severity, shorter duration, and a higher minimum SpO₂ level compared with Group A (P < 0.05). Additionally, Group B required fewer jaw thrust interventions (P < 0.05) and had a significantly lower incidence of injection pain (P < 0.05). No significant differences were found in the incidence of other adverse reactions between the two groups.</p><p><strong>Conclusion: </strong>The ciprofol-remifentanil combination used in painless gastroenteroscopy in obese patients resulted in more stable hemodynamics, significantly reduced respiratory depression, and less injection pain.</p><p><strong>Trial registration: </strong>The trial was registered in the China Clinical Trials Registry (Registration No. ChiCTR2300075619, Date of registration: 11/09/2023).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"497"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of anthropometric and ultrasonographic measurements with different machine learning methods in predicting difficult intubation: a prospective observational study.","authors":"Gizem Demir Senoglu, Ezgi Kara Timucin, Serdar Kırısoglu","doi":"10.1186/s12871-025-03370-x","DOIUrl":"10.1186/s12871-025-03370-x","url":null,"abstract":"<p><strong>Introduction: </strong>Difficult intubation is one of the most challenging scenarios to deal with due to increased morbidity and mortality. Machine learning systems can help predict this process in advance. This study aimed to predict whether patients had difficult intubation using machine learning programs for anthropometric and ultrasonographic measurements taken for preoperative airway assessment.</p><p><strong>Material: </strong>METHOD: Patients over 18 years of age with American Society of Anesthesiologists (ASA) scores I-III who underwent general anesthesia were included. Patients with a history of head/neck surgery, planned thyroidectomy, congenital or acquired airway anomalies morbidly obese patients with BMI > 40 or a known difficult airway were excluded. Preoperative modified mallampati test score and other anthropometric measurements (thyromental distance, neck circumference, mouth opening, sternomental distance) were recorded. Ultrasonographic measurements included the distance from skin to hyoid bone, skin to epiglottis, skin to vocal cords (anterior commissure), skin to trachea, MTT and hyomental distances in neck extension and neutral positions. The dataset was analyzed via eight different machine learning algorithms.</p><p><strong>Results: </strong>We obtained data from 329 patients (62 difficult intubation cases). The Support Vector Machine algorithm achieved the highest performance, with an accuracy of 89.39%, a negative predictive value of 92.7%, and a positive predictive value of 72.7%. Among all evaluated parameters, the modified mallampati score, neck circumference, skin to epiglottic distance and tongue thickness were the strongest predictors of difficult intubation.</p><p><strong>Conclusion: </strong>The ability of individual bedside tests, which are commonly used, to predict difficult intubations is limited. Our study demonstrates that incorporating ultrasonographic measurements into a machine learning model, in addition to clinical airway assessments, improves predictive accuracy. Integrating our predictive model into a mobile app could provide a rapid and objective tool for preoperative airway assessment to identify difficult airways and improve patient safety in anesthesia settings.</p><p><strong>Trial registration: </strong>Prospective Observational.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"496"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraperitoneal ketamine versus bupivacaine for postoperative pain control after laparoscopic cholecystectomy - a double-blind randomized controlled trial.","authors":"Shehrum Bughio, Syed Muhammad Nadeem, Arsala Rahman, Palwasha Khan Kasi, Sadam Hussain, Hanesh Tanwani","doi":"10.1186/s12871-025-03386-3","DOIUrl":"10.1186/s12871-025-03386-3","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"500"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A carbohydrate loading fasting protocol versus 'Sip til Send': a randomised trial of two different fasting protocols at elective caesarean delivery.","authors":"Rana Shoaib Sadiq, Cathriona Murphy, Thomas Drew","doi":"10.1186/s12871-025-03340-3","DOIUrl":"10.1186/s12871-025-03340-3","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary aspiration under general anaesthesia is a rare but serious risk in obstetric populations, leading to conservative fasting protocols prior to elective caesarean delivery (CD). However, prolonged fasting may negatively impact maternal comfort and metabolic status. 'Sip til Send' (STS), a liberal fasting protocol permitting clear fluids until theatre admission, has been shown to improve the perioperative patient experience. Pre-operative carbohydrate loading (CHO), as part of Enhanced Recovery After Surgery (ERAS) pathways, may offer additional benefits, yet its role in obstetrics is underexplored. This study aimed to compare CHO with STS in women undergoing elective CD, focusing on patient-reported comfort measures.</p><p><strong>Methods: </strong>In this single-blinded, randomised controlled trial, 100 eligible women scheduled for elective CD under spinal anaesthesia were randomised to either STS or CHO groups. Women in the CHO group consumed two 200 ml carbohydrate drinks (Nutricia preOp™) pre-operatively. Primary outcomes included self-reported pre-operative thirst, hunger, nausea, dizziness, anxiety, and comfort using a 0-10 visual analogue scale (VAS). Secondary outcomes included ketonuria, blood glucose, lactate levels, intra-operative nausea, post-operative temperature, and recovery scores at 24 h.</p><p><strong>Results: </strong>Mean [SD] anxiety scores were significantly lower in the CHO group compared with STS (CHO 4.1 [2.9] vs STS 5.5 [2.6], p = 0.01. No other primary patient-reported outcomes differed significantly. Ketonuria was less prevalent in the CHO group (CHO 2/50 [4%] vs. STS 10/50 [20%], p = 0.002), and mean [SD] blood glucose was higher (CHO 5.0 [1.5] mmol.L^-1 vs. STS 4.5 [0.6] mmol.L^-1, p = 0.046). Intra-operative nausea was more common in the CHO group (CHO 22/50 [44%] vs. STS 8/50 [16%], p = 0.002). No differences were observed in lactate, post-operative temperature, or quality of recovery scores (OBS QOR-11, global health score) at 24 h.</p><p><strong>Conclusions: </strong>Pre-operative carbohydrate loading before elective CD significantly reduces maternal anxiety and ketonuria compared to a liberal clear fluid protocol. However, it was associated with increased intra-operative nausea and no improvement in other patient-centred outcomes or recovery quality. These findings suggest limited additional benefit of CHO over STS in this population. Further multicentre trials are warranted to refine carbohydrate loading protocols and assess their role in obstetric ERAS pathways.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov NCT06505915, 30th June 2024. Retrospectively registered.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"495"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume-dependent analgesia and dermatomal regression during continuous rhomboid intercostal plane block: lessons from a multiple rib fracture case in intensive care unit.","authors":"Tolga Karaçay, Başak Altıparmak, Canan Gürsoy, Melike Korkmaz Toker","doi":"10.1186/s12871-025-03344-z","DOIUrl":"10.1186/s12871-025-03344-z","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"501"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of esketamine vs sufentanil adjunct to propofol deep sedation on the incidence of oxygen-desaturation in elderly patients undergoing urologic surgeries: a randomized, double-blind, controlled trial.","authors":"Si-Qi Hao, Xue Zhang, Fang-Yu Zhang, Li-Xin An, Xin Luo","doi":"10.1186/s12871-025-03375-6","DOIUrl":"10.1186/s12871-025-03375-6","url":null,"abstract":"<p><strong>Background: </strong>Propofol deep sedation/anesthesia combined with analgesics is always used in minimally invasive urologic surgeries in elderly patients.Oxygen-desaturation is one of the most frequent respiratory complications susceptible to other life-threatening accidents for elderly patients during propofol sedation. The purpose of this study is to evaluate the efficacy and safety of low-dose esketamine adjunct to propofol sedation on the occurrence of oxygen-desaturation, hypotension, propofol requirements and other related adverse events compared to sufentanil for elderly patients undergoing urologic surgeries.</p><p><strong>Methods: </strong>Ninety four elderly male patients undergoing transurethral bladder lesion resection or ureteroscopic ureteral laser lithotripsy were randomly enrolled into esketamine/propofol group (SK group, n = 47) or sufentanil/propofol group (SF group, n = 47). The patients in SK group received 0.25 mg/kg esketamine and 1.5 mg/kg propofol for anesthetic induction and SF group received 0.1 μg/kg sufentanil and 1.5 mg/kg propofol. Sedation was Maintained with 4-6 mg/kg/h propofol infusion. The primary outcome was the incidence of oxygen-desaturation during the surgeries. Second outcomes included induction time, hemodynamic changes, intraoperative propofol dosage, operation duration and anesthesia duration, recovery time, other related adverse events and rescue medication.</p><p><strong>Results: </strong>The incidence of oxygen-desaturation was 34.0% (16 of 47) in SK group compared to 68.1% (32 of 47) in SF group with a significant difference (risk ratio, 0.50; 95% confidence interval, 0.32-0.78; P < 0.001). The overall severity of hypoxiemia was mild in SK group (22/9/16 vs 6/9/32, P = 0.00072). Propofol requirements, induction time were all much lower in SK group than those in SF group (P < 0.001). More hemodynamic stability was observed in SK group compared to SF group. The protective factors of oxygen-desaturation were esketamine (OR:0.26, CI: 0.08 to 0.86, P = 0.027), transurethral bladder lesion resection (OR:0.14, CI: 0.03 to 0.64, P = 0.011). Weight was a hazard factor of OD (OR:1.07, CI: 1.00 to 1.15, P = 0.048). Postoperative sedation score, MMSE, VAS score, incidence of nausea and vomiting were similar in both groups (P > 0.05).</p><p><strong>Conclusions: </strong>Esketamine combined with propofol sedation used in minimal invasive urologic surgeries, could reduce the incidence of oxygen-desaturation, decrease propofol requirements, stabilize hemodynamics and didn't affect the postoperative recovery and neurological function of elderly patients.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, No: ChiCTR2300077170. Registered on 1 November 2023. Prospective registration. http://www.chictr.org.cn .</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"499"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexmedetomidine-dezocine versus propofol-remifentanil anesthesia for ultrasound-guided transvaginal oocyte retrieval: a randomized controlled trial.","authors":"Min Liu, Yong Ouyang, Shi-An Hu, Jie-Dong Zhou, Yu-Ting Xiong, Jin-Long Liu","doi":"10.1186/s12871-025-03381-8","DOIUrl":"10.1186/s12871-025-03381-8","url":null,"abstract":"<p><strong>Background and objectives: </strong>Transvaginal ultrasound-guided oocyte retrieval, a core component of in vitro fertilization-embryo transfer (IVF-ET) techniques, is an outpatient procedure that requires rapid awakening while ensuring adequate analgesia. The currently widely used regimen of propofol-remifentanil presents limitations. The aim of this study was to evaluate the clinical efficacy and safety of dexmedetomidine-dezocine in transvaginal ultrasound-guided oocyte retrieval.</p><p><strong>Methods: </strong>A single-center prospective randomized controlled trial included 124 patients randomly divided into Group D (dexmedetomidine-dezocine, n = 62), and Group P (propofol-remifentanil, n = 62). The primary outcome measure was time to complete wakefulness (time from drug withdrawal to OAA/S score ≥ 4). Secondary outcome measures included intraoperative body movement scale, Ramsay sedation scale, hemodynamic parameters, and adverse reactions.</p><p><strong>Results: </strong>There were no statistical differences between the two groups in intraoperative limb movement grading (p = 0.12), operator satisfaction score (4.65 ± 0.78 vs. 4.55 ± 0.72, p = 0.3348), and patient satisfaction (7.39 vs. 7.10, p = 0.407). Group D had higher oxygen saturation than Group P (97.8% vs. 96.3%, p = 0.002) and a more stable respiratory rate (14.8 ± 2.3 vs. 13.0 ± 2.6, p < 0.001). Group D also had a shorter time to complete wakefulness than Group P (15.02 vs. 15.87 min, minutes, p = 0.019) and a higher Observer's Assessment of Alertness/Sedation (OAA/S) score at the end of the procedure (2.06 vs. 1.64, p = 0.011). Mean arterial pressure and heart rate were not significantly different between the two groups (p = 0.88 and p = 0.93, respectively). The incidence of major adverse events was similar between groups. However, this study did not assess embryo quality or pregnancy outcomes, which represents a limitation.</p><p><strong>Conclusions: </strong>This exploratory study suggests that dexmedetomidine-dezocine regimens may represent a potential anesthetic option for transvaginal oocyte retrieval. However, further research is needed to validate these findings.</p><p><strong>Trial registration: </strong>(TCTR20240601001) [Registered on: 01/06/2024]. This trial is registered with the Thailand Clinical Trials Registry https://www.thaiclinicaltrials.org/ .</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"502"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical pleth index to predict the success of caudal block in pediatric patients under general anesthesia.","authors":"Ruchita Harchandani, Deepali Shetty, Anitha Nileshwar, Handattu Mahabaleswara Krishna, Suvajit Podder","doi":"10.1186/s12871-025-03353-y","DOIUrl":"10.1186/s12871-025-03353-y","url":null,"abstract":"<p><strong>Background: </strong>Caudal block is usually performed after general anesthesia in children, which makes it hard to assess the success of the block. The aim of this study was to determine whether the surgical pleth index can serve as an objective tool for assessing nociception and the success of caudal block in anesthetized children.</p><p><strong>Methodology: </strong>Sixty-two children aged 1-6 years, with American Society of Anesthesiologists Physical Status I and II, undergoing elective infraumbilical surgery, were included. All patients received general anesthesia with i-gel and caudal analgesia. The surgical pleth index, heart rate, and mean blood pressure were recorded throughout the procedure. Caudal block was assessed postoperatively with a gentle pinch.</p><p><strong>Results: </strong>The patients were divided into Group S (caudal success) and Group F (caudal failure). In both groups, the SPI decreased after induction to nearly < 50. It continued to gradually decrease to ≈30 in Group S, whereas it increased sharply with incision in Group F to ≈76. After additional analgesia with fentanyl, the surgical pleth index decreased in Group F, but the mean surgical pleth index was significantly greater than in Group S (p < 0.01). The intergroup difference in surgical pleth index persisted throughout the procedure. A receiver operating curve showed that a surgical pleth index of 43.5 before incision has a sensitivity of 83.3% and a specificity of 67.9% for predicting successful caudal block. Heart rate and blood pressure increased significantly with incision in Group F, unlike in Group S. The intergroup difference in hemodynamics disappeared after additional analgesia.</p><p><strong>Conclusion: </strong>A surgical pleth index of ≤ 43.5 (which may be rounded to 40) can serve as a nociceptive index to predict the success of a caudal block in children.</p><p><strong>Iec registration number: </strong>IEC2 549/2023 dated 19th March 2024.</p><p><strong>Clinical trials registration: </strong>(CTRI/2024/12/078281) dated 18th December 2024.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"492"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}